Provider Demographics
NPI:1881661619
Name:TUMEN, DOUGLAS F (DPM)
Entity Type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:F
Last Name:TUMEN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 HURLEY AVENUE
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:NY
Mailing Address - Zip Code:12401
Mailing Address - Country:US
Mailing Address - Phone:845-339-4191
Mailing Address - Fax:845-331-6894
Practice Address - Street 1:103 HURLEY AVENUE
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:NY
Practice Address - Zip Code:12401
Practice Address - Country:US
Practice Address - Phone:845-339-4191
Practice Address - Fax:845-331-6894
Is Sole Proprietor?:No
Enumeration Date:2006-03-01
Last Update Date:2022-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN003663213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00866064Medicaid
NYP38491Medicare ID - Type Unspecified
NY00866064Medicaid